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Biomedical subjects

R F Miller

Publications and source records attributed to R F Miller.

At least 55 records · Page 3Linked to original sources

Progressive intrathoracic lymphadenopathy: EBV associated non-Hodgkin's lymphoma.

A 30 year old man presented with late stage HIV disease and intrathoracic lymphadenopathy. Histology of a mediastinal biopsy suggested infective follicular hyperplasia or a peripheral T cell lymphoma. Subsequently, Epstein-Barr virus (EBV) infection was demonstrated in lymphocytes in the biopsy. Later, hepatosplenomegaly and peripheral lymphadenopathy developed. Histology of a cervical lymph node biopsy showed EBV associated diffuse large B cell (non-Hodgkin's) lymphoma.

AIDS-Related Opportunistic Infections↗

Peripheral neuropathy in patients with HIV infection: consider dual pathology.

Two HIV infected patients presented with peripheral neuropathy, in one patient this was originally ascribed to HIV associated mononeuritis multiplex and in the other to stavudine. Investigations confirmed these diagnoses and in both cases genetic analysis identified a second hereditary aetiology: in the first patient hereditary neuropathy with liability to pressure palsies and in the second hereditary motor and sensory neuropathy.

Adult↗

Kaposi's sarcoma infiltrating skeletal muscle.

An HIV-1 antibody positive black African man with plasma cell variant Castleman's disease and cutaneous Kaposi's sarcoma, despite receiving chemotherapy, had progressive disease. In addition, he developed pain and swelling behind the right knee. Histology of an ultrasound guided biopsy showed Kaposi's sarcoma infiltrating the head of gastrocnemius.

Adult↗

How voltage-gated ion channels alter the functional properties of ganglion and amacrine cell dendrites.

The present study compares the structure and function of retinal ganglion and amacrine cell dendrites. Although a superficial similarity exists between amacrine and ganglion cell dendrites, a comparison between the branching pattern of the two cell types reveals differences which can only be appreciated at the microscopic level. Whereas decremental branching is found in ganglion cells, a form of non-decremental or "trunk branching" is observed in amacrine cell dendrites. Physiological differences are also observed in amacrine vs ganglion cells in which many amacrine cells generate dendritic impulses which can be readily distinguished from those of the soma, while separate dendritic impulses in ganglion cell dendrites have not been reported. Despite these differences, both amacrine and ganglion cell dendrites appear to contain voltage-gated ion channels, including TTX-sensitive sodium channels. One way to account for separate dendritic impulses in amacrine cells is to have a higher density of sodium channels and we generally find in modeling studies that a dendritic sodium channel density that is more than about 50% of that in the soma is required for excitatory, synaptic currents to give rise to local dendritic spike activity. Under these conditions, impulses can be generated in the dendrites and propagate for some distance along the dendritic tree. When the soma generates impulse activity in amacrine cells, it can activate, antidromically, the entire dendritic tree. Although ganglion cell dendrites do not appear to generate independent impulses, the presence of voltage-gated ion channels in these structures appears to be important for their function. Modeling studies demonstrate that when dendrites lack voltage-gated ion channels, impulse activity evoked by current applied to the cell body is generated at rates that are much higher than those observed physiologically. However, by placing ion channels in the dendrites at a reduced density compared to those of amacrine cells, the firing rate of ganglion cells becomes more physiological and the relationship between frequency and current (F/I relationship) can be precisely matched with physiological data. Recent studies have demonstrated the presence of T-type calcium channels in ganglion cells and our analysis suggests that they are found in higher density in the dendrites compared to the soma. This is the first voltage-gated ion channel which appears more localized to the dendrites than other cell copartments and this difference alone cries for an interpretation. The presence of a significant T-type calcium channel density in the dendrites can influence their integrative properties in several important ways. First, excitatory synaptic currents can be augmented by the activation of T-type calcium channels, although this is more likely to occur for transient rather than sustained synaptic currents because T-type currents show strong inactivation properties. In addition, T-type calcium channels may serve to limit the electrical load which dendrites impose on the spike initiation process and thus enhance the speed with which impulses can be triggered by the impulse generation site. This role whill enhance the safety factor for impulses traveling in the orthograde direction.

Action Potentials↗

Distribution of Pneumocystis carinii f. sp. hominis types in the lung of a child dying of Pneumocystis pneumonia.

Pneumocystis f. sp. hominis causes pneumonia in immunocompromised persons. In order to determine the types and distribution of P. carinii organisms within a single human lung, multiple samples were obtained from the lung of a child who died of P. carinii pneumonia. P. carinii DNA was detected in all of the samples and 2 different genotypes of P. carinii were identified, with uneven distribution in the lung, demonstrating that infection of the human lung is not necessarily clonal, and that different P. carinii genotypes may predominate in different areas of the lung.

Child, Preschool↗

Structure and functional connections of presynaptic terminals in the vertebrate retina revealed by activity-dependent dyes and confocal microscopy.

The fluorescent dyes sulforhodamine 101 (SR 101) and FM1-43 were used as activity-dependent dyes (ADDs) to label presynaptic terminals in the retinas of a broad range of animals, including amphibians, mammals, fish, and turtles. The pattern of dye uptake was studied in live retinal preparations by using brightfield, fluorescence, and confocal microscopy. When bath-applied to the retina-eyecup, these dyes were avidly sequestered by the presynaptic terminals of virtually all rods, cones, and bipolar and amacrine cells; ganglion cell dendrites and horizontal cells lacked significant dye accumulation. Other structures stained with these dyes included pigment epithelial cells, cone outer segments, and Müller cell end-feet. Studies of dye uptake in dark- and light-adapted preparations showed significant differences in the dye accumulation pattern in the inner plexiform layer (IPL), suggesting a dynamic, light-modulated control of endocytotic activity. Presynaptic terminals in the IPL could be segregated on the basis of volume: bipolar varicosities in the IPL were typically larger than those of amacrine cells. The combination of retrograde labeling of ganglion cells and presynaptic terminal labeling with ADDs served as the experimental preparation for three-dimensional reconstruction of both structures, based on dual detector, confocal microscopy. Our results demonstrate a new approach for studying synaptic interactions in retinal function. These findings provide new insights into the likely number and position of functional connections from amacrine and bipolar cell terminals onto ganglion cell dendrites.

Adaptation, Ocular↗

Calcium channel immunoreactivity in the salamander retina.

This study reports the distribution of the alpha1D and alpha1E calcium channel subunits in the neotenous tiger salamander retina based on immunohistochemical techniques. Confocal and light microscopy were used to localize staining with fluorescently tagged antibodies to alpha1D and alpha1E in cross-sectional and flatmount preparations of retina. Alpha1D-immunoreactivity (alpha1D-IR) was localized to the inner and outer plexiform layers (IPL and OPL, respectively), ganglion cell layer (GCL), and optic fiber layer. Alpha1E-IR was found predominantly in the IPL, with scattered, weak representation in the OPL. Alpha1E-IR was not detected in the GCL or fiber layer. These findings suggest that different alpha1 calcium channel proteins have distinctive distributions in retina, which may reflect their unique and different roles in retinal processing and homeostasis.

Ambystoma↗

Pneumocystis carinii f. sp. hominis DNA in immunocompetent health care workers in contact with patients with P. carinii pneumonia.

The possible transmission of Pneumocystis carinii f. sp. hominis from patients with P. carinii pneumonia to asymptomatic health care workers (HCW), with or without occupational exposure to human immunodeficiency virus (HIV)-infected patients with P. carinii pneumonia, was examined. HCW in a specialist inpatient HIV-AIDS facility and a control group in the general medical-respiratory service in the same hospital provided induced sputum and/or nasal rinse samples, which were analyzed for the presence of P. carinii f. sp. hominis DNA by using DNA amplification (at the gene encoding the mitochondrial large subunit rRNA [mt LSU rRNA]). P. carinii f. sp. hominis DNA was detected in some HCW samples; those with the closest occupational contact were more likely to have detectable P. carinii DNA. P. carinii DNA was detected in one HCW who carried out bronchoscopy over a 2-year period. P. carinii-positive samples were genotyped by using DNA sequence variations at the internal transcribed spacer (ITS) regions of the nuclear rRNA operon, along with bronchoalveolar lavage samples from patients with P. carinii pneumonia hospitalized at the same time. Genotyping identified 31 different P. carinii f. sp. hominis ITS genotypes, 26 of which were found in the patient samples. Five of the eight ITS genotypes detected in HCW samples were not observed in the patient samples. The results suggested that HCW in close occupational contact with patients who had P. carinii pneumonia may have become colonized with P. carinii. Carriage was asymptomatic and did not result in the development of clinical disease.

DNA, Fungal↗

HIV associated nephropathy: a treatable condition.

OBJECTIVES: To describe current knowledge on the aetiology, pathology, diagnosis, and treatment of HIV associated nephropathy. METHODS: A Medline search was performed using the key words "HIV," "nephropathy," "renal," and "kidney." A further search was performed for each of the currently licensed antiretroviral agents linked to key words "renal" or "kidney" and also using the MeSH heading "pharmacokinetics." RESULTS: HIV associated nephropathy is a common complication of HIV in black African and Afro-Caribbean patients and presents with progressive renal failure and heavy proteinuria. As other causes of renal failure are likely to fall in incidence among patients successfully treated with highly active antiretroviral therapy (HAART), HIV associated nephropathy will become increasingly prominent as a cause of renal impairment in HIV infected patients. Recent evidence suggests that HIV associated nephropathy will respond to HAART with a dramatic improvement in renal function. CONCLUSION: HIV associated nephropathy is a treatable condition. This condition should be actively sought in HIV infected patients if they are to receive the benefits of therapy.

Adult↗

Presentation, diagnosis, and management of renal failure in patients with HIV infection.

HIV infected patients are at increased risk of developing renal failure when compared to the general population. Renal disease occurs both as a primary manifestation of HIV infection and secondary to complications such as intercurrent illness or drug therapy. Examples of primary HIV renal disease, including HIV associated nephropathy (HIV AN) and immune complex glomerulonephronephritis, and secondary causes of renal failure are reviewed with full discussion about investigation and treatment methods.

AIDS-Associated Nephropathy↗

Rehabilitative care of war-related health concerns.

The objective of this study was to pilot the effectiveness of a 3-week rehabilitative intervention that used medical review, graded exercise, education on Gulf War exposures, active coping, and nutrition to improve disability and related distress for Gulf War veterans with persistent symptoms. One hundred and nine veterans were assessed at program entry and exit and at 1 and 3 months after program completion. Outcomes were physical symptoms, quality of life, physical health concern, and psychosocial distress--contrasted across time and demographic groups. After treatment, veterans showed modest and global improvements; women were more likely than men to show improvement. The finding that Gulf War veterans who completed specialized rehabilitative management experienced modest, short-term improvements is encouraging, given that veterans of the conflict remain concerned about their future health. Controlled studies are needed.

Adult↗